COMPARISON OF TRAMADOL AND FENTANYL AS ADJUVANTS TO INTRATHECAL 0.5% HYPERBARIC BUPIVACAINE FOR LOWER ABDOMINAL AND LOWER LIMB SURGERIES

Dr. Ankit Sawhney; Dr. Smita Joshi; Dr. Hashim Qadri; Dr. Amey Sable

Volume : IX, Issue : III, March - 2019

COMPARISON OF TRAMADOL AND FENTANYL AS ADJUVANTS TO INTRATHECAL 0.5% HYPERBARIC BUPIVACAINE FOR LOWER ABDOMINAL AND LOWER LIMB SURGERIES

Dr. Ankit Sawhney, Dr. Smita Joshi, Dr. Hashim Qadri, Dr. Amey Sable

Abstract :

Introduction: Intra thecal administration of Opioids as adjuvant, has been established to provide effective and prolonged postoperative analgesia in surgical procedures. 6000 fold reduced affinity of Tramadol for μ receptors, can be attributed to decreased incidence of its respiratory depressant effects. Methodology: A prospective, randomized, single blinded study was conducted on 60 adult patients with ASA 1 & 2 status, posted for elective lower abdominal or lower limb surgeries. Patients in Group ‘T’ were given 25mg of Tramadol with 15mg of 0.5% Bupivacaine and Group ‘F’ were given 25mcg of Fentanyl with 15mg of 0.5% Bupivacaine, in spinal anaesthesia. Along with vital parameters, the time of onset of sensory and motor block, maximum level reached, time for regression, total duration of sensory block and analgesia in terms of VAS score, were recorded. Results: Change in vital parameters in the initial few minutes was comparable. Values on Modified Bromage scale were statistically significant during the first 2 minutes. Among the variables assessed, the time taken to reach the maximal dermatomal level, time to 2 segment regression, total duration of sensory block and the incidence of side effects were found to be statistically highly significant between the two groups. Conclusion: Quality and length of both anaesthesia and analgesia is irrefutably better with Fentanyl as adjuvant when compared to Tramadol.